(SBQ12SP.84)
A 50-year-old woman presents for followup two years after having cervical spine surgery through a left-sided approach with severe neck pain. A recent radiograph is seen in Figure A. Her surgeon advises her that she will need revision surgery. Preoperative laryngoscopy shows abnormal left vocal cord function because of paralysis of the left posterior cricoarytenoid muscle. What approach would be CONTRAINDICATED during revision surgery?
Review Topic

QID:
3782

FIGURES:

A

1

Revision ACDF with a right-sided approach due to superior laryngeal nerve palsy

4%

(153/4128)

2

Revision ACDF with a left-sided approach due to superior laryngeal nerve palsy

1%

(48/4128)

3

Revision ACDF with a right-sided approach due to recurrent laryngeal nerve palsy

83%

(3422/4128)

4

Revision ACDF with a left-sided approach due to recurrent laryngeal nerve palsy

(OBQ07.148)
A 33-year-old male presents with neck and left arm pain. He denies symptoms in his right arm. Based on the MRI image shown in Fig A, what findings would be expected on physical exam?
Review Topic

(OBQ13.45)
A 28-year-old man presents with pain in the distribution shown in Figure A, and numbness in the middle finger. After performing a complete neurological exam, his surgeon orders an MRI of his cervical spine. Which of the following motor exam findings and MRI findings are consistent with the symptoms present?
Review Topic

(OBQ06.82)
A 38-year-old male presents with a cervical disc herniation at the C7/T1 level with associated foraminal stenosis, but no significant central stenosis. What would be the expected symptoms and physical exam findings.
Review Topic

QID:
193

1

Numbness of the lateral shoulder and deltoid weakness

1%

(16/2907)

2

Numbness of 2nd and 3rd fingers and triceps weakness

12%

(335/2907)

3

Numbness of the thumb with weakness to wrist extension

2%

(53/2907)

4

Numbness of 5th finger with weakness to long flexor function in all digits and thumb

57%

(1668/2907)

5

Numbness of the medial elbow and weakness to long finger flexion of the 4th and 5th digits only

(OBQ09.199)
A 59 year-old man complains of acute pain radiating from the neck down the right upper extremity. Physical exam demonstrates right arm triceps weakness, decreased triceps reflex, and diminished sensation of the middle finger. A cervical disk herniation will likely be found at which level?
Review Topic

(SBQ09SP.6)
A 49-year-old male presents with left arm pain of four weeks duration. A T2-weighted axial MRI is shown in Figure A. Which of the following statements would most accurately describe his diagnosis and physical exam findings?
Review Topic

QID:
3369

FIGURES:

A

1

A C5 radiculopathy leading to deltoid and biceps weakness.

18%

(416/2363)

2

A C5 radiculopathy leading to brachioradialis and wrist extension weakness.

2%

(37/2363)

3

A C5 radiculopathy leading to triceps and wrist flexion weakness.

1%

(18/2363)

4

A C6 radiculopathy leading to brachioradialis and wrist extension weakness.

(OBQ05.257)
A 50-year-old diabetic woman describes left arm pain and tingling in the ulnar side of her hand and wrist. She denies weakness or trouble with fine motor tasks. Her symptoms are worse when she is sleeping without a pillow on her left side, and with her left elbow in an extended position. Sleeping with her left hand above her head seems to improve her symptoms. What is the most likely diagnosis?
Review Topic

(OBQ10.88)
Treatment options for a symptomatic cervical pseudoarthrosis following anterior cervical diskectomy and fusion include revision anterior surgery versus a posterior instrumented cervical fusion. When comparing these treatment options, all of the following are true of posterior cervical fusion EXCEPT:
Review Topic

(OBQ12.197)
A 57-year old male presents with right arm pain of 4 weeks duration. He reports the pain began following a tennis match and has not improved with time. He describes the pain as an aching sensation that affects his lateral forearm that improves when he abducts the shoulder. He also describe a sensation of numbness in this right thumb. Reflex exam shows he has 1+ right biceps reflexes and 2+ right triceps reflexes which are both symmetric with the left side. Sensory exam shows paresthesias in the distribution of the right thumb. Motor exam shows no evidence of radial deviation with active wrist extension. Motor exam on the right shows 5/5 deltoid, 5/5 elbow flexion with the palms facing upward, 4/5 wrist extension, and 5/5 elbow extension, and 5/5 wrist flexion. What is the most likely etiology of his symptoms.
Review Topic

QID:
4557

1

Tendinosis and inflammation at origin of ECRB

6%

(263/4088)

2

Compression of the posterior interosseous nerve by the proximal edge of supinator

(OBQ05.119)
A 52-year-old woman underwent a C5/6 ACDF for cervical radiculopathy through a left-sided approach two years ago. Radiographs are shown in Figure A. She has had an altered voice since this operation. Recently, the patient has developed myelopathic symptoms including gait instability and dexterity problems with her hands. An MRI shows a fusion at C5/6, and an adjacent-level midline disc herniation at C4/5 with cord compression and myelomalacia. Laryngoscopy of the vocal cords demonstrates abnormal function of the vocal cords on the left hand side. Which of the following is the most appropriate treatment for this patient?
Review Topic

QID:
1005

FIGURES:

A

1

Physical therapy and NSAIDS

1%

(25/2220)

2

High dose methylprednisone

0%

(7/2220)

3

C5/6 hardware removal and C4/5 ACDF using a left sided anterior approach

86%

(1903/2220)

4

C5/6 hardware removal and C4/5 ACDF using a right sided anterior approach